Topics in Geriatrics:Group Exercise to Promote Wellness in the Geriatric Population
Group exercise is an avenue that can be used in the geriatric population to address and prevent many chronic health conditions and prevent life-altering falls. This form of physical exercise promotes social wellbeing, self esteem, and is cost effective for a community.
Objectives:
The objectives of this page are to:
Understand some of the important deficits that develop commonly in older adults
Learn about different group exercise options
Learn about the evidence related to the ability group exercise to address deficits in older adults.
Learn concrete steps to take when recommending group exercise to older adult patients.
Information About Aging and Group Exercise
Information on Aging
As our society’s population ages there will be a sharp increase in the number of seniors in coming decades. This will also include a proportional increase on ‘older elders’ who are older than 75 years old. This population is faced with many chronic health conditions such as cardiovascular disease, diabetes, respiratory disease, arthritis, dementia, and cancer. Also with advanced aging comes and increased rate of falls and fear of falling, which inhibits function and community participation. One final factor of note facing this population is increased social isolation, due to the aforementioned health conditions or mental and emotional health decline.
Information on Group Exercise
Group exercise classes consists of community members gathering to complete an exercise routine together with an instructor guiding them through the class. Specific classes that are often geared toward older adults include the following. Silver sneakers, yoga, tai chi, and aquatic exercise. Who should I utilize community based group exercise classes?
Seniors who are community dwelling who have been cleared by their physician are appropriate for senior focused group exercise classes.
Evidence for Use of the Tinetti Balance Assessment
According to Maritz, exercise programs are widely accepted as an appropriate tool to use with older adults, and even frail elderly, to address chronic disease. Maritz demonstrated that group exercise programs led to positive changes in both TUG and POMA scores. Villafane et al compared those enrolled in group exercise, balance training, and specific core stabilization exercises. They found that group exercise programs improved balance and functional mobility in just three weeks, which can decrease the chance of falls.
In addition to the physical benefits of group exercise, Kleinert et al, have explored the link between exercise and physical self-esteem. It is established that general self-esteem and physical self-esteem declines dramatically after age 60. Self-esteem is linked to how individuals rate their mental health, with those evaluating themselves positively having more positive mental health with regards to emotional stability, hardiness, controllability, along with lower levels of mental disorder. So the decline in self-esteem in older adults impairs health itself and may even be linked to unhealthy behavior like sedentary life style and social restriction, which then adds additional health risks. Kleinert et al argue that group exercise is a valid and effective way to reverse this decline in physical self-esteem by improving feelings of competence in physical function and contributes to feeling of belongingness and being part of a group. In Sung’s interventional study, he found that elderly Korean women who were enrolled in a group exercise program saw improvements in functional abilities and self-esteem, and both are important to cardiovascular health. These findings applied to older elderly and younger elderly women.
King and Eitivipart suggest that aquatic therapy can improve balance and prevent falls. Aquatic therapy is particularly helpful for those with joint arthropathies, osteopathies, and obesity due to decreased ground reaction forces. This is particularly important in these populations because they may not otherwise exercise. Movements in water are slower, so there is more time for neurological processes to take place that detect movement errors and generate balance reactions compared to non-aquatic movements, which could lead to greater confidence in movement.
Suggestions:
Encourage and help elderly patients gain physician approval for group exercise if it does not exist.
Provide senior specific exercise class resources to interested patients of classes such as tai chi, yoga, aquatics.
Recommend aquatic therapy for patients with joint arthropathies, osteopathies, and obesity.
Recommend and facilitate engagement in group exercise for those patients with low physical self-esteem.
Recommend and facilitate engagement in group exercise for those with balance deficits.
References
Sung, K., The Effects of 16-Week Group Exercise Program on Physical Function and Mental Health of Elderly Korean Women in Long-Term Assisted Living. Journal of Cardiovascular Nursing. 24(5):344-351, September/October 2009.
Maritz C. Using a model of reciprocal mentorship to develop, implement, and sustain a group-based exercise program for the frail elderly. Physical & Occupational Therapy in Geriatrics. January 2008:26(3):41-56. Available from CINAHL Complete, Ipswich, MA
Kleinert J, Pels F, Podlog L. The Presence of an Exercise Instructor or Group Members Affects Physical Self-Concept and Physical Self-Esteem: An Experimental Study in the Elderly. Health (1949-4998). July 2014;6(13):1616-1627. Available from: CINAHL Complete, Ipswich, MA.
King A, Eitivipart C. Systematic Review of Published Research on Aquatic Exercise for Balance in the Elderly. Journal Of Aquatic Physical Therapy. Winter 2016;24(1):9-21.
Villafane J, Pirali C, Buraschi R, Arienti C, Corbellini C, Negrini S. Moving forward in fall prevention: an intervention to improve balance among patients in a quasi-experimental study of hospitalized patients. International Jounal of Rehabilitation Research. December 2015;38(4):313-319.
Group exercise is an avenue that can be used in the geriatric population to address and prevent many chronic health conditions and prevent life-altering falls. This form of physical exercise promotes social wellbeing, self esteem, and is cost effective for a community.
Objectives:
The objectives of this page are to:
Information About Aging and Group Exercise
Information on Aging
As our society’s population ages there will be a sharp increase in the number of seniors in coming decades. This will also include a proportional increase on ‘older elders’ who are older than 75 years old. This population is faced with many chronic health conditions such as cardiovascular disease, diabetes, respiratory disease, arthritis, dementia, and cancer. Also with advanced aging comes and increased rate of falls and fear of falling, which inhibits function and community participation. One final factor of note facing this population is increased social isolation, due to the aforementioned health conditions or mental and emotional health decline.
Information on Group Exercise
Group exercise classes consists of community members gathering to complete an exercise routine together with an instructor guiding them through the class. Specific classes that are often geared toward older adults include the following. Silver sneakers, yoga, tai chi, and aquatic exercise.
Who should I utilize community based group exercise classes?
Seniors who are community dwelling who have been cleared by their physician are appropriate for senior focused group exercise classes.
Evidence for Use of the Tinetti Balance Assessment
According to Maritz, exercise programs are widely accepted as an appropriate tool to use with older adults, and even frail elderly, to address chronic disease. Maritz demonstrated that group exercise programs led to positive changes in both TUG and POMA scores. Villafane et al compared those enrolled in group exercise, balance training, and specific core stabilization exercises. They found that group exercise programs improved balance and functional mobility in just three weeks, which can decrease the chance of falls.
In addition to the physical benefits of group exercise, Kleinert et al, have explored the link between exercise and physical self-esteem. It is established that general self-esteem and physical self-esteem declines dramatically after age 60. Self-esteem is linked to how individuals rate their mental health, with those evaluating themselves positively having more positive mental health with regards to emotional stability, hardiness, controllability, along with lower levels of mental disorder. So the decline in self-esteem in older adults impairs health itself and may even be linked to unhealthy behavior like sedentary life style and social restriction, which then adds additional health risks. Kleinert et al argue that group exercise is a valid and effective way to reverse this decline in physical self-esteem by improving feelings of competence in physical function and contributes to feeling of belongingness and being part of a group. In Sung’s interventional study, he found that elderly Korean women who were enrolled in a group exercise program saw improvements in functional abilities and self-esteem, and both are important to cardiovascular health. These findings applied to older elderly and younger elderly women.
King and Eitivipart suggest that aquatic therapy can improve balance and prevent falls. Aquatic therapy is particularly helpful for those with joint arthropathies, osteopathies, and obesity due to decreased ground reaction forces. This is particularly important in these populations because they may not otherwise exercise. Movements in water are slower, so there is more time for neurological processes to take place that detect movement errors and generate balance reactions compared to non-aquatic movements, which could lead to greater confidence in movement.
Suggestions:
References
Additional Resources